Health Care

Delivery System
 01 Millennium Development Goals

02 Sustainable Development Goals

03 Department of Health

Content 04 Classification of Health Facilities

H E A LTH CA RE D E LI V E RY S Y ST EM
Outline 05 Philippine Health Agenda

Topics for discussion

05 Philippine
Primary Health
Health Agenda
Care

05 Levels of Prevention

05 Universal Health Care

Millennium
Development
Goals
The Millenium Development Goals are set of eight goals agreed by
world health leaders. In September 2000, leaders of 189 countries
agreed to set of time bound from 1990 – 2015 and measurable goals
for combating hunger, poverty, disease, illiteracy, environmental
degradation, and discrimination against women.
The 8 MDG’s
 Sustainable
Development
Goals
 Sustainable Development Goals

The Sustainable Development Goals (SDGs) were adopted

by the United Nations in 2015 to replace the Millennium
Development Goals (MDGs). They contain 17 goals
covering a broad range of sustainable development issues
for the world, such as ending poverty, hunger, improving
health and education, combating climate change, etc.
 But the work of nurses also has a major impact on the delivery of
other SDGs such as education and poverty – these are often referred
to as the social determinants of health (SDH). The SDH are the
conditions in which people are born, grow, work, live and impact on
the conditions of health and daily lives. While nurses seek to help
people achieve their optimal health, our work frequently includes
addressing the Social determinants of health (SDH) and nurses
understand the links between wider conditions and individual and
population health.
WHAT ARE THE SUSTAINABLE
DEVELOPMENT GOALS?
GOAL 1: NO POVERTY
Poverty is often the central factor of this disempowerment. It
affects social hierarchy, and limits children’s intellectual and social
development. From an early age, conditions are set in place that hinders people
from reaching their potential. The mixture of what happens in early life
profoundly impacts life in later years. More adverse conditions in early
childhood lead to fewer educational opportunities, fewer opportunities for
good and meaningful work, low income, worse environments, high rates of
smoking, poor diet, increased alcohol and drugs.
GOAL 2: ZERO HUNGER, IMPROVED NUTRITION
There are few challenges facing the world today that can
compare with scale of malnutrition. Malnutrition affects one in three
people and it has been estimated that it is the underlying cause of 45% of
child deaths. Malnutrition keeps people from reaching their full potential.
It manifests itself in many ways: as poor child growth and development;
as individuals who are prone to infection; as those who are carrying too
much weight or who at risk of chronic diseases because of increased
intake of salt, fat, sugar or those who are deficient in important vitamins
and minerals.
GOAL 3: GOOD HEALTH AND WELLBEING
Today, for the first time in history, non-communicable diseases
have overtaken infectious diseases as the leading causes of mortality across
the world. Economic growth, modernization and urbanization have opened
wide the entry point for the spread of unhealthy lifestyles. Whilst many
health systems have been designed to meet the needs of acute infections,
the changing profile of disease means that many systems are not prepared
to manage conditions requiring long term and sometimes lifelong care.
GOAL 4: QUALITY EDUCATION
This goal ensures inclusive and equitable quality
education and promotes lifelong learning for all. Sadly, COVID-19
reversed years of education gains, and many countries lack basic
school infrastructure.
 GOAL 5: GENDER
EQUALITY
SDG 5 targets to achieve gender equality and empower all
women and girls. The percentage of women who work in national
parliaments, local governments, and in managerial positions is still
significantly less than that of men. Not to mention 1 in 3 women are subject
to violence at least once since the age of 15, and child marriage is still
highly present.
GOAL 6: CLEAN WATER AND SANITATION
Dirty water and the lack of safe toilets are among the top five
killers of women worldwide. Without these basic facilities, health centres
cannot adequately prevent and control infections, placing mothers and their
children at risk during delivery. Where latrines are not provided, mothers in
labour may have to go outside to relieve themselves, and tend to leave
health facilities within hours of giving birth, leaving little time for them to
receive advice and support.
GOAL 7: AFFORDABLE AND CLEAN ENERGY
Insufficient access to clean energy has a profound and wide
reaching effect on health. Almost 800 million people lack access to
electricity and 1/3 of the population uses dangerous cooking systems. This
puts into perspective why this goal aims to ensure affordable, reliable,
sustainable, and modern energy.
GOAL 8: DECENT WORK AND
ECONOMIC GROWTH
Especially after the global pandemic, joblessness and
unemployment is extremely prevalent, making this goal of promoting
sustained, inclusive, and sustainable economic growth and productive
employment and decent work ever more important.
GOAL 9: INDUSTRY INNOVATION
AND INFRASTRUCTURE
In many small towns, the local hospitals are unable to provide
chemotherapy because of the low number of cancer patients which means
that few staff have the required competencies in the administration of
chemotherapy. If patients are to receive care, they are often required to
travel long distances for extended periods of time.
GOAL 10: REDUCED INEQUALITIES
This sustainable development goal focuses on reducing
inequalities within and among countries. Income inequality, the refugee
crises, and inequality indexes all show that certain areas and countries are
highly more beneficial to live in than others. Living standards between
countries are very unbalanced.
GOAL 11: SUSTAINABLE CITIES
AND COMMUNITIES
The rapid growth of population in the city has been a major
factor in this disparity. Planning has not been able to keep pace with the
rapid expansion, meaning that services such as sanitation and wastewater
management, mobility, building standards, indoor air quality and
communication are inadequate.
GOAL 12: RESPONSIBLE CONSUMPTION
AND PRODUCTION
Hospitals and health services are large consumers of resources
and produce significant amounts of waste. Healthcare facilities have a
significant contribution on the sustainability of resources. They also have a
direct impact on individuals’ health. WHO believes that only 58% of
healthcare waste is disposed of in the correct way.
 GOAL 13: CLIMATE ACTION
The impacts of climate change are not limited to a few. It
affects all of us. Nurses and nursing organizations are often early adopters
of strategies that affect the health of populations and are therefore at the
forefront of issues such as climate change.
GOAL 14: LIFE BELOW WATER
Care for our oceans and waterways is crucial. They provide
natural resources including food, medicines, biofuels and other products.
They support the breakdown and removal of waste and support climate
change mitigation an adaption efforts.
GOAL 15: LIFE ON THE LAND
Stable ecosystems are vital to sustaining human life. All aspects
of human well-being depend on ecosystem goods and services, which in
turn depend on biodiversity. With the loss of biodiversity and changes to
ecosystems, the results can be devastating. There can be outbreaks of
infectious diseases, undermining of the development progress, it can risk
food and nutrition security as well as protection from natural disasters.
 GOAL 16: PEACE, JUSTICE AND STRONG
INSTITUTIONS
Our humanity depends on everyone’s humanity. We will not be
judged on our scientific and technological advances, nor on how we treat
the rich and the powerful, but rather how we treat the poor, the condemned,
the displaced and the incarcerated.
 GOAL 17: PARTNERSHIP FOR THE GOALS
The health sector cannot work in isolation if it is to truly enable
prevention strategies to take effect. We need to work in tandem with
industry and other government departments. When the health sector works
in tandem with others, it can generate huge benefits. It can even tackle a
powerful, devious, and dangerous industry on multiple fronts, including
through fiscal and regulatory measures.
Department
of
Health
 Department of Health
Vision:
Filipinos are among the healthiest people in Southeast
Asia by 2022, and Asia by 2040
Mission:
To lead the country in the development of a productive,
resilient, equitable and people-centered health system for
Universal Health Care
 3 roles and functions of DOH
Leadership in Health
-serves as an advocate in the adoption of health policies, plans and programs to address
national and sectoral concerns

Administrator of Specific Service

-administer health emergency response services including referral and networking system

Enabler and Capacity Builder

-innovates new strategies in health to improve the effectiveness of health programs
 Overriding Goals of DOH
-Health Sector Reform Agenda (HSRA)

Framework for it's Implementation:

-FOURmula One for Health (Arroyo)
-Universal Healthcare/ Kalusugan Pangkalahatan (Aquino)

-All for Health towards Health for All (Duterte)

Goals:
1. Financial Protection
2. Better Health Outcome
3. Responsiveness

Values:
1. Equitable and inclusive to all
2. Transparent and accountable
3. Uses resources efficiently
4. Provides high-quality services
Strategies:
1. Advance quality, health promotion and primary care.
2. Cover all Filipinos against health-related financial risk.
3. Harness the power of strategic HRH development.
4. Invest in eHealth and data for decision-making.
Strategies:
5. Enforce standards, accountability and transparency.
6. Value all clients and patients, especially the poor,
marginalized, and vulnerable.
7. Elicit multi-sectoral and multi-stakeholder support for
health.
Classification of
Health Care
Facilities
 Philippine
Health Agenda
 PHILIPPINE HEALTH AGENDA 2010-2022
All for Health towards Health for All
 GOALS
The health system we aspire for:
1.Financial protection
- Filipinos especially the poor, marginalized and vulnerable are protected
from high cost of healthcare
2. Better health outcomes
- Filipinos attain the best possible health outcomes with no disparity.
3. Responsiveness
- Filipinos feel respected, valued, and empowered in all of their interaction
with the health system
 VALUES
The health system we aspire for:
1.Equitable and inclusive to all
2.Uses resources efficiently
3.Transparent and accountable
4.Provides high quality services
During the last 30 years of Health Sector Reform, we have undertaken
key structural reforms and continuously built on programs that take us a
step closer to our aspiration
Milestone:
1.Devolution
2.Use of generics
3.Milk code
4.Philhealth (1995)
5.DOH resources to promote local health system development
6.Fiscal autonomy for government hospitals
7.Good Governance Programs (ISO, IMC, PGS)
8.Funding for UHC
 All for Health towards Health for All
(Lahat Para sa Kalusugan! Tungo sa Kalusugan Para sa Lahat)
 
AMBISYON NATIN 2040 (Duterte’s Administration)
Universal Health Coverage
Strengthen Implementation of RPRH Law
War against drugs
Additional Funds from PAGCOR
 
 Attain Health-Related SDG Targets
Values: Equity, Quality, Efficiency, Transparency,
Accountability, Sustainability, Resilience
 
3 Guarantees:
All life stages and triple burden of disease
- Services for both the well and the sick
Services delivery network
- Functional network of health facilities
Universal health insurance
- Financial freedom when accessing services
Our Strategy:
 Primary
Health Care
 Primary Health Care
Primary health care is any medical service that is
provided outside the four walls of a hospital,
including general practice, aged care, schools,
community health and other primary health care
settings.
 Primary Health Care
The World Health Organization (WHO) adopted the primary
health care approach as the basis for effective delivery of health
services. The primary health care approach is both a philosophy
of health care and an approach to providing health services, and
embraces five types of care: promotive; preventive; curative;
rehabilitative; and supportive. The principles of primary health
care are accessibility, public participation, health promotion,
appropriate technology and intersectoral cooperation.
 Five Types of Care
Promotive Care
Health promotion is the development of the individual,
group, institutional, community, and systemic strategies to
improve health knowledge, attitudes, skills, and behavior.

Preventive Care
Preventive care helps detect or prevent serious diseases
and medical problems before they can become major.
 Five Types of Care
Curative Care
Curative or therapeutic care refers in part to treatments and
therapies provided to a patient with the goal of curing an illness
or condition.

Rehabilitative Care
Rehabilitation is care that can help you get back, keep, or
improve abilities that you need for daily life. These abilities may
be physical, mental, and/or cognitive (thinking and learning).
 Five Types of Care
Supportive Care
An interdisciplinary medical caregiving approach aimed at
optimizing quality of life and mitigating suffering among
people with serious, complex, and often terminal illnesses.
 Principles of Primary Health Care
Accessibility means that the five types of health care are
universally available to all clients regardless of geographical
location.

Public Participation means clients are encouraged to participate

in making decisions about their own health, in identifying the
health needs of their community, and in considering the merits
of alternative approaches to addressing those needs.
 Principles of Primary Health Care
Appropriate Technology means that modes of care are
appropriately adapted to the community’s social, economic
and cultural development. Adoption of the principle of
appropriate technology highlights the importance of
improved knowledge and of on-going capacity building to
the design and delivery of health care services.
 Principles of Primary Health Care
Health Promotion involves health education, nutrition,
sanitation, maternal and child health care, immunization,
prevention and control of disease. The goal of health promotion
is to reduce the demands for curative and rehabilitative care.

Intersectoral Cooperation recognizes that health and well-being

is linked to both economic and social policy Intersectoral
cooperation is needed to establish national and local health
goals, healthy public policy, and the planning and evaluation of
health services.
 Levels
of
Prevention
 There are three levels of prevention,
including primary, secondary and tertiary, that
are used by the health field to prevent
diseases, diseases and adverse health
conditions.
1. Primary prevention describes interventions aimed at
preventing the occurrence of illness, injury, or disability
-primary prevention strategies focus on a population
that does not have a disease that an initiative seeks to
prevent.
-these actions are the first type of preventive
behaviors that are conducted before the problems occur.
2. Secondary prevention describes initiatives aimed at early
detection and treatment of the disease before signs and
symptoms appear.

- secondary prevention includes measures taken to identify

diseases or negative health conditions before the patient
presents any signs or symptoms.
-secondary prevention involves early detection and
treatment of a disease to prevent or slow progression.

-With early detection and intervention, secondary

prevention strategies can be effective and significantly
improve health care outcomes.
3. Tertiary prevention includes steps taken to control
or mitigate negative health conditions after a
diagnosis has been made
-tertiary prevention involves ongoing medical
care as a way to relieve symptoms of a negative
health condition.
 - tertiary prevention aims to reduce the severity of
a disease after it has developed and to improve the
quality of life of people with a disease.

- tertiary prevention targets people with a known

disease, with the goal of limiting or preventing
future complications.
Universal
Health Care
UNIVERSAL HEALTH CARE
Means that all people and communities can use the
promotive, preventive, curative, rehabilitative, and
palliative health services they need, of sufficient quality to
be effective, while also ensuring that the use of these
services does not expose the user to financial hardship.
Universal Health Care and Its Aim

Universal Health Care (UHC), also referred to as Kalusugan

Pangkalahatan (KP), is the “provision to every Filipino of the
highest possible quality of health care that is accessible,
efficient, equitably distributed, adequately funded, fairly
financed, and appropriately used by an informed and
empowered public”.1 The Aquino administration puts it as
the availability and accessibility of health services and
necessities for all Filipinos.
It is a government mandate aiming to ensure that every
Filipino shall receive affordable and quality health
benefits.This involves providing adequate resources – health
human resources, health facilities, and health financing.
UHC’s Three Thrusts

To attain UHC, three strategic thrusts are to be pursued,

namely: 1) Financial risk protection through expansion in
enrollment and benefit delivery of the National Health
Insurance Program (NHIP); 2) Improved access to quality
hospitals and health care facilities; and 3) Attainment of
health-related Millennium Development Goals (MDGs).
→ Financial Risk Protection

Protection from the financial impacts of health care is attained by making

any Filipino eligible to enroll, to know their entitlements and
responsibilities, to avail of health services, and to be reimbursed by
PhilHealth with regard to health care expenditures. PhilHealth operations
are to be redirected towards enhancing national and regional health
insurance system. The NHIP enrollment shall be rapidly expanded to
improve population coverage. The availment of outpatient and inpatient
services shall be intensively promoted. Moreover, the use of information
technology shall be maximized to speed up PhilHealth claims processing.
→ Improved Access to Quality Hospitals and Health Care Facilities

Improved access to quality hospitals and health facilities shall be

achieved in a number of creative approaches. First, the quality of
government-owned and operated hospitals and health facilities is
to be upgraded to accommodate larger capacity, to attend to all
types of emergencies, and to handle non-communicable diseases.
 Financial efforts shall be provided to allow immediate
rehabilitation and construction of critical health facilities. In
addition to that, treatment packs for hypertension and diabetes shall
be obtained and distributed to RHUs.

The DOH licensure and PhilHealth accreditation for hospitals and

health facilities shall be streamlined and unified.
→ Attainment of Health-related MDGs

Further efforts and additional resources are to be applied on

public health programs to reduce maternal and child mortality,
morbidity and mortality from Tuberculosis and Malaria, and
incidence of HIV/AIDS. Localities shall be prepared for the
emerging disease trends, as well as the prevention and control of
non-communicable diseases.
 The organization of Community Health Teams (CHTs) in each priority
population area is one way to achieve health-related MDGs. CHTs are
groups of volunteers, who will assist families with their health needs,
provide health information, and facilitate communication with other health
providers. RNheals nurses will be trained to become trainers and
supervisors to coordinate with community-level workers and CHTs.
Another effort will be the provision of necessary services using the life
cycle approach. These services include family planning, ante-natal care,
delivery in health facilities, newborn care, and the Garantisadong Pambata
package.
 Better coordination among government agencies, such as DOH, DepEd,
DSWD, and DILG, would also be essential for the achievement of these
MDGs.